Provider Demographics
NPI:1689975575
Name:CRAIG, TRISHA JUNE
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:JUNE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 S WENATCHEE AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2264
Mailing Address - Country:US
Mailing Address - Phone:509-888-2750
Mailing Address - Fax:
Practice Address - Street 1:23 S WENATCHEE AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2264
Practice Address - Country:US
Practice Address - Phone:509-888-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool